Organization
ST LOUIS HEMATOLOGY ONCOLOGY SPECIALISTS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DEBORAH GONZALEZ (PRACTICE MANAGER)
(314) 645-3370
Entity
Organization
Contact information
Practice address
6400 CLAYTON RD, SUITE 302, SAINT LOUIS, MO 63117-1850
(314) 645-3370
(314) 645-0576
Mailing address
6400 CLAYTON RD, SUITE 302, SAINT LOUIS, MO 63117-1850
(314) 645-3370
(314) 645-0576
Taxonomy
Speciality
Code
Description
License number
State
207RH0003X
Hematology & Oncology Physician
Primary
R8B76
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
117296
BLUE CROSS BLUE SHIELD
MO
01
—
CS2438
RAILROAD MEDICARE
MO
Enumeration date
08/05/2006
Last updated
04/20/2008
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